Wish Registration Form

*Limit 1 Wish for 1 family
Please Take Note:
1. Submission of a wish does not guarantee its approval or fulfilment.
2. Each individual or family may submit only one wish for consideration. Duplicate or multiple submissions from the same household will not be accepted.
3. If your wish is chosen for consideration, you will receive a phone call from Great Heart Charity Association (in 1-2 weeks time) to run a simple assessment and you may be required to provide a few supporting documents.
We know that, given your current situation, certain dreams may feel distant or even impossible. But just
for a moment, if you could have something, go somewhere, or meet someone. What would you wish for,
and why? And how can we be there to help bring that dream a little closer?


My wish is to... (required)

Please share the details of your wish with us.

The reason I hope this wish can be fulfilled is because... (required)
Please tell us why this wish means so much to you, so we can better understand the significance and importance of it.

Once my wish is fulfilled, the change I hope to see is... (required)
Tell us how you believe fulfilling this wish will bring a meaningful and positive transformation to your life or someone else’s.

Full Name (required)

IC Number (required)

Contact No. (required)

House Address (required)

Number of Household Members (required)

Estimated Total Monthly Household Income (RM) (required)

List out any external aid received (if any) (required)

Please state organization or referrer's details (Name, Contact number, Relationship. If any) (required)

  1. Eligibility: Wish submissions are open to individuals residing in West Malaysia who meet the criteria of being resides below the poverty line, indigenous people, single-parent households, elderly individuals living alone, people with disabilities, as well as cancer or dialysis patients.
  2. Submission Process: Wishes must be submitted through the designated platform, such as a Google Form, WhatsApp, or phone call. Each submission should include the wish details, including the specific item, service, or experience requested, along with a brief explanation of the need or reason behind the wish.
  3. Verification: All wish submissions are subject to verification to ensure eligibility and authenticity. Additional information or documentation may be requested to validate the need for the wish.
  4. Selection Process: Wish selection will be based on various factors, including feasibility, genuine necessity, and available resources.
  5. Limitations: Each individual or family may submit only one wish for consideration. Duplicate or multiple submissions from the same household will not be accepted.
  6. Privacy: Personal information provided during the wish submission process will be kept confidential and used solely for the purpose of wish fulfillment. By submitting a wish, individuals consent to the use of their information for this purpose.
  7. Approval: Submission of a wish does not guarantee its approval or fulfilment. The organizing committee reserves the right to reject or modify wishes based on feasibility, budget constraints, or other considerations.
  8. Notification: Selected individuals will be notified of the status of their wish via the contact information provided during the submission process. It is the responsibility of the wish submitter to ensure that their contact information is accurate and up to date.
  9. Acceptance: By submitting a wish, individuals acknowledge and agree to abide by these terms and conditions. They also consent to the use of their name and appearance for promotional purposes related to the wish fulfilment event.
  10. Discretion: The organizing committee reserves the right to interpret and enforce these terms and conditions at its discretion. Decisions regarding wish selection and fulfilment are final and not subject to appeal.
  11. Modification:  These terms and conditions may be subject to modification or update at any time without prior notice. Participants are encouraged to review the terms periodically for any changes.
  12. About Handover Ceremony: If your wish is approved, you will be invited and encouraged to attend our Handover Ceremony, which is expected to take place in July 2025. Wish fulfillment will begin after the ceremony, or earlier if deemed urgent.
By submitting the form, I acknowledge that I have read and understand the Terms and Condition written above.